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Climent et al. Mini-invasive Surg 2018;2:45 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2018.62

Review Open Access

Complications of laparoscopic rectal cancer surgery

Marta Climent, Sean T. Martin

Department of Colorectal Surgery and Centre for Colorectal Diseases, St. Vincent’s University Hospital, Dublin 4, Ireland.

Correspondence to: Dr. Sean T. Martin, Department of Colorectal Surgery and Centre for Colorectal Diseases, St. Vincent’s
University Hospital, Elm Park, Dublin 4, Ireland. E-mail: drseanmartin@gmail.com

How to cite this article: Climent M, Martin ST. Complications of laparoscopic rectal cancer surgery. Mini-invasive Surg
2018;2:45. http://dx.doi.org/10.20517/2574-1225.2018.62
Received: 14 Sep 2018 First Decision: 19 Sep 2018 Revised: 26 Oct 2018 Accepted: 28 Nov 2018 Published: 28 Dec 2018

Science Editor: Gordon N. Buchanan Copy Editor: Cui Yu Production Editor: Huan-Liang Wu

Abstract
Laparoscopic rectal cancer surgery has widely been adopted over the past decade. With technical advances, data have
shown equivalent outcomes with open surgery. In this paper, we discuss the potential complications of laparoscopic
anterior resection, the need for early recognition and prompt management.

Keywords: Rectal cancer, postoperative complications, laparoscopic anterior resection

INTRODUCTION
Laparoscopic anterior resection (LAR) is currently a routine practice in specialized high-volume centres,
[1-3]
with equivalent oncological outcomes in historical, open surgery . Appropriate pelvic dissection can be
measured by the adequacy of circumferential margin (CRM) and distal margin, both are risk factors of local
recurrence. No difference in CRM positivity has been shown in patients undergoing open and LAR in the
[1]
large, multicentre randomised controlled trials, such as the CLASSIC trial (14% vs. 16%, respectively). LAR
remains a technically challenging technique, particularly in the male pelvis, because of limited space in the
pelvic cavity. It is estimated that a learning curve of 60-80 resections are required to obtain proficiency .
[4]
[5]
Data suggest that the learning curve is an important risk factor for postoperative complications .
Similarly, many data exist to suggest that postoperative complications may promote tumour recurrence
and decrease long-term survival , although there is no general consensus among patients undergoing low
[6,7]
[8]
anterior resection for rectal cancer . Post-operative complications can be classified according to time-line
[1,8]
related to surgery , although most authors use well-known classification systems such as Clavien-Dindo
[9]
[Table 1].
© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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